Micah Deshaun Martin
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
1420 Valwood Pkwy Ste 170
Carrollton
, Texas 75006-8312
Micah Deshaun Martin
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
1420 Valwood Pkwy Ste 170
Carrollton
, Texas 75006-8312
(918) 814-5898
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About
Features
Specialties
- Nurse Practitioner - Adult Health
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Micah Deshaun Martin
- 5275 Town And Country Blvd Apt 2448
- Frisco, TX
- Zip : 75034-6257
- Phone : (918) 814-5898
Second Address
- Micah Deshaun Martin
- 1420 Valwood Pkwy Ste 170
- Carrollton, TX
- Zip : 75006-8312
- Phone : (918) 814-5898
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | AP136599 | TX |
| N | 363LG0600X | Nurse Practitioner - Gerontology | AP136599 | TX |
National Provider Identifier
| NPI | 1073002960 |
|---|---|
| Provider Name | Micah Deshaun Martin |
| First Address | Frisco, TX 75034-6257 |
| Second Address | Carrollton, TX 75006-8312 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/05/2018 |
| Last Update Date | 07/05/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.